Foreword

Glioblastomas remain a conundrum in neuro-oncology, and the perception of a given generation of physicians and clinician scientists has somehow always been that progress is tedious, if visible at all. Looking beyond generations, however, it is clear that progress in understanding the molecular genesis of these tumors, their genetics and epigenetics, and also their clinical therapy is being made. Over the years, the prognosis of these tumors has been slowly improving as therapies are becoming more complex. Gone are the days in which the basic tenets of therapy were surgery by the youngest and the least experienced neurosurgeons, without early imaging to assess resection rates, followed by simple radiotherapy. Current surgical strategies are complex, encompassing complex intraoperative imaging combined with sophisticated mapping and monitoring, striving for maximal resections while maintaining function and quality of life. These are standard in specialized centers. State-of-the art surgery is followed by molecular classification of tumors and multidisciplinary decisions regarding chemotherapy and radiotherapy. Second and third operations are not uncommon, as are second courses of radiotherapy and varying, individualized chemotherapy regimens. Patients can now participate in a large number of clinical trials. Thus, even though glioblastoma remains a devastating tumor, the knowledge about this disease is rapidly expanding. Read more…..